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235 Cards in this Set

  • Front
  • Back
What is a characteristic sound heard with tracheal collapse?
Honking
Tracheal collapse is what type of condition?
An acquired, end-stage disease
The sx approach to the trachea is to bluntly dissect which muscles?
Sternothyroideus and sternohyoideus
What are some of the surgical methods used to correct tracheal collapse?
-dorsal membrane plication
-external tracheal splints
-internal tracheal splints
The trachea has what type of blood supply?
Segmental
When performing surgery on the trachea, which nerve do you need to watch out for?
Recurrent laryngeal
External Tracheal spiral splints are placed between the trachea and what other structures?
Neurovascular structures
What are the disadvantages of the external spiral tracheal splint?
-extensive surgical approach
-anesthetic risk
prolonged post op care and pain
-other segment may collapse
What is the big advantage to using internal tracheal splints?
Delivered by catheter...no surgery required
Entire trachea treated at 1 time
In adult dogs, how much of the trachea can be resected?
25% - 50%

(in puppies 20%-25%)
What type of sutures must be used in tracheal resection?
Tension sutures
What device is used post op of a tracheal resection to assist in healing?
A harness that holds the dog's head in a downward position
When anastomozing the trachea, which surface is sutured first?
Back wall
How do you checks for leaks in the trachea prior to closing?
Bubble test with saline
After performing a tracheotomy ot tracheostomy, what activity should the dog never engage in?
Swimming
What suture pattern is used to suture the tracheal mucosa to the skin in creating a tracheostomy?
Mattress
What is the definition of a diaphragmatic hernia?
Continuity of the diaphragm is disrupted leading to protrusion of the abdominal viscera into the thoracic cavity
Name the 3 types of diaphragmatic hernias.
Circumferential, radial, combined
Congenital diaphragmatic hernias are not true hernias because....
No serosal lining
Congenital diaphragmatic hernias are traumatic how often?
93% of the time
What are the 3 types of Congenital diaphragmatic hernias?
-pleuroperitoneal
-peritneo-pericardial
-hiatal
When a dog has been involved in a HBC, and has a fx, what other area should you check?
Diaphragm....2% of dogs with fractures have diaphragmatic hernias
What are the clinical signs of a traumatic diaphragmatic hernia?
-dyspnea
-tachypnea
-cyanosis
-orthopnea
-muffled heart sounds
-borboygmus
-vomiting
-chronic cough
-excercise intolerance
-tucked up abdomen
In which position would these signs worsen?
Wheelbarrow
What is the length of time between trauma and diagnosis?
hours to 6 years
What diagnostic imaging procedures are used to help diagnose diaphragmatic hernia?
-radiographs (contrast)
-ultrasound
-fluoroscopy
Fluoroscpy is most helpful in evaluating what type of hernia?
Hiatal
What are some of the radiographic signs of diaphragmatic hernia?
-interruption of diaphragmatic outline
-soft tissue density in thorax
-gas-filled viscera in thorax
-loss of cardiac silhouette
-incidental finding
Why might you hear borborygmus when auscultating the chest in the case of a diaphragmatic hernia?
Intestines may be in the pleural space
Surgical repair of diaphragmatic hernia carries a higher mortality rate if it is perfomed when?
< 24 hours after the occurrence or > 1 year after the occurrence
Which timing of repair has the highest mortality?
When performed < 24 hrs
When can diaphragmatic hernia repair be made?
When the patient is stable enough for anesthesia
How is the success rate of diaphragmatic hernia surgery improved?
By delaying surgery 1-3 weeks
What is the first step in treating a traumatic diaphragmatic hernia?
Correct the life-threatening conditions first...
-shock
-hypovolemia
-hemorrhage/bleeders
-cardiac arrhythmia
-electrolyte/acid-base balance
Why is a traumatic diaphragmatic hernia an emergency?
If the stomach has herniated into the thoracic cavity..a dilating stomach will cause complete and rapid collapse of the lungs
What is the advantage of the abdominal approach for repair?
-more familiar
-provides bilateral access
-can be extended by sternotomy or paracostal incision
(reqs ventilatory support of patient)
What makes the throacic approach more challenging?
-only 1 side approach (accurate Dx)
-experience with throacic sx
-need good visualization
-suturing over a convex surface
What is the definition of a hernia?
The protrusion of the abdominal content included in a peritoneal sac through a natural or acquired opening
What are the components of a hernia?
-hernial ring (ing. ring or muscle)
-hernial sac
-hernial content
-peritoneal lining
Define "eventration."
Protrusion of the abdominal content through a debilatated area of the abdominal wall due to a surgical or traumatic origin with an intact skin
Define "evisceration."
The rupture of all the structures constituent of the abdominal wall with the protrusion of the visceral content, through a wound or surgical incision
What does it mean when a hernia is incoercible?
Is reduced but pops back out
What is an incarcerated hernia?
impossible reduction of the hernia into the abdomimal cavity, with no alteration yet in the blood supply to the hernial content
What is a strangulated hernia?
Impossible reduction of the hernia into the abdominal cavity with vascular compromise to the protruded viscera
What caution must be taken with a strangulated hernia?
Do not attempt manual reduction, possible rupture of the involved organ
What are the clinical signs of umbilical hernia?
-deformation
-reducible/irreducible
-redness/pain
-symptoms will depend on the content
When should an umbilical hernia be repaired?
ASAP
What are the principles of herniorrhaphy?
-return all viable content to the abdominal cavity
-close the hernial ring to prevent occurrences
-obliteration of redundant tissue in the hernial sac
-use the patient's own tissues whenever possible
What do you do when repairing a hernia, if the edges are necrotic?
Use scalpel blade to debride
What suture pattern is used to close a hernia repair?
Vest over pants
Which hernia type is the most difficult to repair?
Inguinal hernia
What is the difference between an indirect and direct inguinal hernia?
Indirect- herniates into the vaginal process

Direct- herniates into a prescrotal opening
What are some of the DDX's for inguinal hernia?
-abscess
-mammary neoplasia
-neoplasia from another origin
-hematoma
-inguinal lymph node
-fat
-eventration
What type of hernia is a cord like structure through the inguinal ring towards the scrotum?
Scrotal hernia
Diagnosis of a scrotal hernia is made in which position?
Dorsal recumbency
(use U/S when in doubt)
A femoral hernia can be palpated in which position?
Standing on hind legs
A perineal hernia is a rupture of what?
Of the pelvic diaphragm
What is a typical signalment for a patient with perineal hernia?
-male (93%)
-adult (7-9 years)
-non-castrated (95%)
-2/3 unilateral
-right sided
What are some of the possible causes of perineal hernia?
-neurogenic atrophy
-senile atrophy
-myopathies
-endocrine disorders
-prostatomegaly
-constipation & tenusmus
A perineal hernia can often contain what structure?
Urinary bladder
Perineal hernias in the dog can be of what configurations?
-flexure
-saccule
-dilatation
-diverticle (real, false)
Which ligament is not found in the pelvic diaphragm of the cat?
No sacrotuberous ligament
Clinical signs of perineal hernia include what?
-constipation
-tenesmus
-inflammation
-edema
-dysuria
-anal dilatation
-rectal mucosal prolapse
What 2 approaches are used for perineal hernia repair?
-perineal
-lateral

do not use trendelnburg
How many sutures are needed to close the perineal hernia repair?
7
What are the post op complications are perineal hernia repair?
-rectal prolapse
-incontinence
-dehiscence
-sciatic nerve lesion
What is the reoccurence rate of perineal hernia?
10-46%
Sciatic nerve lesions occur 5% of the time from perineal hernia repair. What iatrogenic cause can affect the sciatic nerve?
Entrapment by sutures
What is the most common perineal tumor of intact male dogs?
Perineal gland adenoma
Which perineal neoplasia is most common in female dogs?
Aprocrine cell adenocarcinoma of the anal sac or aprocrine gland adencarcinoma
Aural surgery is a contaminated procedure, therefore what type of perioperative drugs are given?
Antibiotics
What are the treatment options for an aural hematoma?
-incise, evacuate hematoma, suture
-aspirate hematoma, steroid injection into space? place pressure bandage?
-cannula/catheter drainage
What conditions of the external ear are indications for surgery?
-otitis externa
-stricture of the ear canal
-neoplasia of the ear canal
Clinical signs of otitis externa usually always include what?
Shaking of head, scratching
How are acute cases of otitis externa treated?
Medically- clean ear, systemic abi for 3 weeks
treat for mites or fungal infection
What surgical approaches are used for treatment of chronic otitis externa?
-lateral ear canal resection
-vertical ear canal resection
-total ear canal ablation, combined with lateral bulla osteotomy (TECA-LBO)
What is the name of the lateral ear canal resection procedure?
Lacroix or Zepp
When performing a vertical ear canal resection, which facial structures do you need to watch for?
facial nerve
parotid gland
The final suture line of the vertical ear canal resection forms what shape?
A "T"
Which instrument is used to remove the medial bony portion of the bulla during the TECA LBO procedure?
Rongeurs
What is a nasopharyngeal polyp?
Inflammed and hyperplastic epithelium of the bulla, projects into the pharynx through the auditory tube
A nasopharyngeal polyp could be confused with what?
Neoplasm
Cannula drainage of a hematoma can be performed using what type of cannula?
A teat cannula
What condition can occur secondarily to otitis externa?
Otitis media
True or False. In the cat, otitis media is always preceeded by otitis externa
false- otitis media can occur on its own
What are some of the clinical signs of otitis media?
-head tilts, esp if associated with nystagmus, circling, vestibular dysfunction
-facial nerve deficits
-nausea, vomiting
Horner's
How should a nasopharyngeal polyp be treated?
-pulled back into the bull and removed with the epithelium
-if polyp resected in pharynx or external ear canal. stalk should be pulled into the bulla and removed with epithelium
What are the indications for performing a bulla osteotomy?
-otitis media
-nasopharyngeal poly
-neoplasm of epithelium of bulla
What will happen if the tissue lining of the bulla is not removed during a bulla osteotomy?
Infection will return
What is different about the bulla of the cat vs the dog?
In the cat the bulla is divided into craniolateral and craniomedial compartments....both must be opened
What are potential complications from a bulla osteotomy?
-Horner's- esp in cats, resolves in 2-3 weeks
-facial nerve paralysis
-vestibular dysfunction
-superficial wound infection
Describe the architecture of the sublingual salivary gland
-caudal is monostomatic
-rostral is polystomatic
Name the major salivary glands in the dog
-partoid
-mandibular
-sublingual
-zygomatic
What additional major salivary gland is found in the cat?
Molar salivary gland
What are some of the minor salivary glands?
-lingual
-labial
-buccal
-palatine
The minor salivary glands open into where?
Directly into the oral cavity
What are some of the disease conditions of the salivary system?
-mucocele
-parotid fistula
-sialotliths
-sialoadenitis
-canaine necrotizing sialometaplasia
canine sialoadenosis
-neoplasia
On physical exam, what is the appearance of a salivary system problem?
Notable swelling
A needle aspiration of a salivary gland cyst will give a fluid that leads to what common name?
Honey cyst
what radiographic procedure can demonstrate the salivary system, helping to rule out a rupture of the duct?
Sialogram
What is a salivary mucocele?
Subcuntaneous (submucosal) accumulation of saliva with non-epithelial non-secreting lining
What is the most common disease of the salivary system in the dog and cat?
Salivary mucocele
Which gland is most affected?
Sublingual salivary duct (monostomatic portion)
90% of salivary duct ruptures occur on which side?
Left
What is the most common location for a sublingual gland mucocele?
Cervical
What is a ranula?
sublingual accumulation
What is a sequelae of of pahryngeal mucocele?
Obstructs the airway....drain first
A cat with a zygomatic gland mucocele will have swelling in what region?
Periorbital
What are the clinical signs of a mucocele?
Soft, non-painful swelling

(pharyngeal= respiratory distress)
What is the definitive tx for salivary mucocele?
Surgical removal of the involved gland
After removal, what is the chance of re-occurance of a mucocele?
Less than 5%
What is a sialolith?
Salivary duct stones
What is the most commonly affected gland in the dog?
Parotid
How can you differentiate the swelling of a mucocele from the swelling of a sialolith?
Sialolith is painful
How is a sialolith removed?
Through an oral incision over the duct
Sialoadenitis is usually a secondary condition due to what?
Trauma or systemic infection
Which gland is most affected with sialoadenitis?
Zygomatic salivary gland
What is the current thought as to the cause of a parotid fistula?
Result of trauma to the parotid duct
What is the tx for parotid fistula?
Ligation of the parotid gland...results in atrophy by day 5
Salivary gland neoplasia is uncommon..which breed of cat is more commonly affected?
Siamese
What other conditions can cause salivary gland enlargement?
-canine necrotizing sialometaplasia
-canine sialadenosis
What are 3 possible causes of failure of erection in the dog?
-psychological constraints
-pain
-androgen insufficiency (uncommon)
What are some cause of failure to ejaculate seen in the dog?
-age (young dogs may copulate before maturity)
-pain
-effects of pharmacological agents
-retrograde ejaculation
Retrograde ejaculation is rare, what drugs are used to tx it?
-sympathomimetic drugs
(phrenylpropanoloamine, pseudoephedrine)
What are the cause in failure to copulate seen in dogs?
-age (too young, too old)
-overuse
-psychological constraints
What is the definition of laryngeal paralysis?
Failure of the laryngeal cartilages to abduct on inspiration as a result of degeneration of the recurrent laryngeal nerve and paralysis of the cricoarytenoideus dorsalis muscle
What is the eitiology of laryngeal paralysis?
Wallerina degeneration of the recurrent laryngeal nerve from unknown causes
In which species is laryngeal paralysis see?
Medium and large breed dogs, occasionally cats

associated with hypothyroidism in dogs
What history or clinical signs will be seen in cases of laryngeal paralysis?
-inspiratory dyspnea
-stridor
-change in voice
-cyanosis
-hot weather exacerbates signs
What surgical approaches can be used to reapair laryngeal paralysis?
-partial areytenoidectomy (ventriculocordectomy)

-arytenoid cartilage lateralization (tie back)

-laryngoplasty ( castellatated laryngofissure)
Why is an arytenoidectomy done partially?
To reduce the chance of aspiration
For the arytenoid cartilage lateralization technique, where do you tie the cartilage?
Tie back to the thyroid and areteynoid with non-absorbable sutures
What are the possible complication of arytenoid cartilage lateralization?
Aspiration pnemuonia (do only 1 side)

Failure to correct condition
-inadequate lateralization
-failure to correct associated hypothyroidism
-misdiagnosis of cause of dyspnea
What is brachecephalic airway syndrome?
-primary upper airway characteristics of stenotic nares, elongated soft palate and hyoplastic trachea

-secondary syndrome include everted laryngeal saccules and laryngeal collapse

-signs of upper airway obstruction
How could you treat brachycephalic airway syndrome medically?
-weight loss
-reduced exercise
-harness
-steroid for short term
-sedatives
-avoid hot environment
What 2 surgical procedures could be performed on stenotic nares?
-alaplasty
-alapexy
How is alapexy performed?
Two elliptical incisions are made and sutured together on the nare side...will pull nares open
How do your treat the elongated soft palate surgically?
Resection
remember to cut less than you think, healing will cause the palate to retract further

Folded flap palatoplasty
What is the surgical treatment of choice for laryngeal collapse?
Permanent tracheostomy
With an otoscope, ho far into the nose can you see?
Rostral 1/3 of cavity
How would you perform a core biopsy of the nasal cavity?
-under anesthesia
-measure cannula against muzzle before inserting
-12 cc syringe, cannula
A dorsal approach to exploratory rhinotomy allows access to which structures?
Rostral nasal cavity and sinuses
What would a ventral approach to exploratory rhinotomy give you access to?
Entire nasal passage, including area caudal to the ethmoid turbinates
Why would an exploratory rhinotomy be performed?
-establish drainage, remove f.b.
-diagnostic procedure for biopsy and culture
-may be indicated for treatment (adenocarcinoma)
How do you define the term fracture?
Interruption of the continuation of a bone
What terms are used for the general classification of bone fx?
-plane
-direction
-fragments
Addtional classfication of fx include the fractures reducibility and...
-stability
-bone protrusion (open or closed)
When discussing a fx with a colleague over the phone it helps to speak in a common language which would include telling him/her the bone and place of fx and what else?
-number of fragments
-soft tissue status (open/closed)
When classifying long bone fractures, the soft tissue wounds in an "open" fracture can be classified into how many categories?
4
I,II, IIIa, IIIb, IIIc
What are the definitions of soft tissue categories I and II?
I wound < 1 cm, clean

II wound > 1 cm moderate soft tissue trauma
What are the definitions of open soft tissue classifications of III a,b,c
IIIa: severe soft tissue trauma, wound coverage possible

IIIb: tissue loss, bone exposed, periosteal stripping

IIIc: blood supply impaired, arterial repair necessary
What is the name of the classifications of physeal fractures?
Salter Harris
What are SH I and SH II fracture?
SH I: fx along the physis

SHII: fx along physis into metaphysis
What are SH III and SH IV fractures?
SH III: fx at physis and epiphysis

SH IV: fx at physis, metaphysis and epiphysis
What are SH V and SH VI fractures?
SH V: compression of the physis

SH VI: compression 1 section of the physis
Why does a bone fracture?
Increasing load and deformation from which the bone cannot recover- energy is released at fx site
What is the difference in healing between soft tissue and bone?
Soft tissue heals by scar formation
Bone heals by forming new bone
What are the goals of fracture repair?
-anatomical reduction
-stable fixation
-blood supply preservation
-early mobilization
Why is early mobilization important?
To reduce the amount of atrophy
What 3 patterns of healing are seen at a fracture site?
-adequate blood supply
-spontaneous healing
-mechanical stability (osteosynthesis)
Unstable fractures are subjected to natural stabilization which include what processes?
-muscular contraction
-resorption of bone edges
-deposition of suitable tissues
-prominent callus formation
How is an unstable fracture defined?
More than one fragment
True or false. Unrestricted movement will cause a larger bone callus to form.
True
The type of tissue cells that respond to a fracture is determined by the what of the fracture gap?
Strain (or movement) or deformation of the gap

100% = non-union
10% = fibrous/granulation
2-10% = cartilage formation
2% = direct bone formation
What are the 3 phases of healing in an unstable, unrestricted movement fracture?
indirect- second healing
1. inflammation
2. repair
3. remodeling
Phase 1 of indirect secondary healing, inflammation, lasts for how long and includes what events?
lasts 3-4 days
-hemorrhage
-bone ischemia
-necrosis
-vascular endothelium angiogenesis
The vascular response to healing is affected by what?
Soft tissue injury
Blood is supplied to the healing bone fracture site by what organ?
Muscles
In phase 2 of indirect secondary healing, repair, what happens to the hematoma at the fx site?
Is replaced with granulation tissue (elongates to twice its length)

Granulation tissue rapidly infiltrated by collagen
3 weeks after a fracture, what type of callus has formed?
a bridging or soft callus
Mineralization of the gap occurs in what direction?
From the ends to the center of the gap
What substances do the mitochondria release during fx repair?
-calicum containing graules (hypoxic environment)

-Ca phosphate forms apatite micro crystals
What occurs during phase 3 of indirect secondary healing of a fx?
Remodeling- slow morphological adaptation for function and strength
Remodeling of the bone is dependent of the mechanical forces placed on it. What is the name of these forces (converted to energy)
Piezoelectricity
Restricted movement of a healing fracture will have what benefits?
-osteogenic intensity
-increased bone density
-biomechanical strength
A stable bone fracture has how many fragments?
2
What is the functional unit of bone?
osteon
In stable fractures with contact healing, new bone forms in which direction?
Axial
The fx gap in the contact healing process is bridge with bone by what structure?
Cutting cone
What comprises the front and back end of the cutting cone?
Front: osteoclasts- cuts channel to other side of fx

back: osteoblast (lays down new bone)
Contact healing occurs if the gap is of what size?
< .01 mm/ strain <2%
A stable fracture gap up to 1 mm (strain 2%) is healed by what process>
Gap healing
What are the step in gap healing?
-gap fills with intramembranous bone (perpendicular to long axis)
-2 weeks, gap filles, fragments unite
-3-8 weeks haversian remodeling
-osteons proliferate longitudinally
What are some of the conditions that influence bone healing?
-metabolic dz
-hormonal imbalance
-neoplasia
-nutrition
-protein deificiecy
-diabetes
-age
-hypoxia
-drugs
-infection
soft tissue at site
Will bones heal in the presence of infection?
Yes
The healing pattern of a bone fx will differ with what?
The method of fixation
Fractures heal faster with what?
Limited motion
What is a key to fracture healing?
Preservation of blood supply
What is the best method to simulate fracture healing?
Cancellous bone graft
Why is a Cancellous bone graft so helpgul in healing?
-provides a scaffold for osteoproginator cells
-contains viable osteoproginator cells
-bioactive bone including factors
-no immune reactions
-no transmitted dz
Why isn't stripping the periosteum a good technique for stimulation of bone healing?
Decreases blood supply
When do you perform the cancellous bone graft?
At the end of the fx repair sugery
What is the theory of the biological approach to osteosynthesis?
-avoid soft tissue trauma
-avoid rigid fixation
-vascular injury in minimized
-periosteal stripping is limited
What orthopedic device will give soft tissue integrity and less rigid fixation?
IM pins
interlocking nails
external fixators
ring fixators
Fractures located where near more rigid fixation?
Closer to joints
Withour rigid fixation near joints, what disease can develop?
DJD
Why is "over plating" a fracture a detriment to healing?
The forces of walking (healing) go through the plate not the bone
What are 3 potential complications to bone healing?
-delayed union
-non-union
-malunion
What factors can cause delayed union of a fracture?
-impaired blood supply
-movement
-initial management
-wrong ortho technique
-implant failure
-inadequate post op care
What are the clinical signs of delayed union of a fx?
-use of limb
-pain
-movement at site
-muscle atrophy
What radiographic signs of delayed healing might be seen?
Sequential films might show...
-limited bone resorption
-mineralized callus
-open medullary cavity
-evidence of fx line
What is the treatment for a delayed union of a fx?
-confine, wait and observe
-reoperate
-cancellous.cortical bone graft
-biomaterials
-external coaptation, internal fixation
In the case of a nonunion failure of fx healing, what type of bone is viable?
-hypertrophic
-slightly hyperthrophic
-oligotrophic
In the case of a nonunion failure of fx healing, what type of bone is non- viable?
-dystrophic
-necrotic
-defect
-atrophic
What are some of the causes of non-union fracture healing?
-impaired blood supply
-movement
-initial management
-wrong ortho technique
-implant failure
-inadequate post op care
-interposition of soft tissue
-comminuted fractures
-open fx/infection
-metabolic dz
How do you diagnose non-union?
-lamness
-muscular atrophy
-movement of fx site
-pain
How is non-union of a fx seen radiographically?
-persistant gap
-sclerotic ends
-closed medullary cavity
-sequestra
What is the treatment for non-union of a fx?
-surgical approach
-debridement
-implant removal
-osteotomy of sclerotic ends
-open medullary cavity
-lavage
-bone graft
-rigid fixation
What is amlunion of a fx?
Fracture heal without anatomical alignment
What hx and clinical signs are seen in malunion?
-gait abnormalities
-regional deformation
-lameness

radiographically:
-angular deformity
-shortening
-rotational deformity
What is the most common cause of post traumatic osteomyelitis?
bacterial, nosocomial infection
(of open fxs)
What 2 general conditions result in bone infection?
contamination + inadequate blood supply
What develops on an ortho implant that promotes osteomyelitis?
Biofilm which allows bacterial adhesions
what are the clinical signs of osteomyelitis?
-lameness
-fever
-depression
-anorexia
-local pain
-swelling
What signs are seen if the osteomyelitis infection if chronic?
-local signs only
-fistulous tratcs
What are the radiographic signs of ostemyelitis?
-periosteal proliferation
-bone resorption
-areas of increased density
-bone lysis
-sequestra
-loose implants
What re the treatment goals for a case of osteomyelitis?
-culture and sensitivity
-improvement of fx site
-abi therapy
What steps can you take to help heal osteomyelitis?
-aggressive debridement
-elimination of biofilm
-implant removal
-remove foreign material
-lavage
-open drainage
- muscle flaps
-rigid fixation
What is the average age of 55% of dogs and cats with growth plate factures?
Under 1 year
Why does angular limb deformity occur after a physis fracture?
Bone stops growing on one side due to fx, other bone (radius/ulna) continues to grow and bends
Why is it important to make a fast diagnosis in growth plate fractures?
Bone callus forms fast!
what steps should you take in the case of a growth plate fx?
-immobilize
-accurate anatomical reconstruction
-bne soft/friable
-prevent further fragment injury
-avoid cartilage damage
-select proper ortho method
Which ortho device provides anti-rotation for repair of a growth plate fx?
Lag screw
Is a SH I fracture likely to close the physis prematurely?
No, unlikely
A SH II (in a dog over 6 months) is likely to cause what kind of defect upon healing?
Angular limb deformity due to callus
Which growth plate fx is an emergency and requires immediate attention?
SH III through the epiphysis
If a SH III fx is not perfectly reduce, what will occur in the future?
Arthritis
Which SH fx type is very unstable and requires immediate reduction?
SH IV, through metaphysis, physis and epiphysis
How quickly must sx be performed to correct a SH V fracture?
Does not require suregry
Why are articular fxs in adults difficult to deal with>
-fx reduction must be exact
-need special instruments
-articular cartilage has low healing potential
-for cartilage nourishment movement and weight bearing are needed
Joint osteosynthesis should not be attempted unless....
You have precise knowledge of the joint's anatomy
Anatomically, when should osteosynthsis not be undertaken?
-when the fx cannot be anatomically reduced
What is the benefit to early mobilization in fx healing?
-prolonged immobilization leads to joint stiffness
-exercise stimulates cartilage healing
-(pain prevents early mobilization)
-bandaging may be necessary
What is the prognosis for an articular fx in an adult?
-unfavorable
-long term arthrosis likely
-depends on joint that is fx and surgeon's expertise
-damage to cartilage